REPRODUCTIVE ANATOMY

Dr. Marie Faith B. Villaruz, M.D. FPOGS

By: Kae, Darleen and Louvelle

Thin, moist-mucous membrane

Stratified squamous epithelium
No hair follicles
Few sweat glands
Extremely sensitive-nerve endings
Posteriorly-fourchette
Lower pair fuse to form the frenulim
Upper pair fuse to form the prepuce

--CLITORIS

--PUDENDA/VULVA

Pubisperineum
Mons pubis, labia majora, labia minora,
clitoris, hymen, vestibule, urethral opening,
glandular and vascular structures

--MONS PUBIS

Male scrotum
Vary in appearance
7-8 cm in length
2-3 cm in width
1.5 thick
Posterior commissure
Rich in sebaceous glands and adipose tissue
No muscular element

--LABIA MINORA

--VESTIBULE

Mons veneris
Escutcheon
o Females-triangular
o Males-not well circumscribed

--LABIA MAJORA

Vary in size and shape

Principal female erogenous organ

Homologue of the penis
Superior portion of the vulva, between the
labia minora
Glans, corpus, 2 crura
2 cm in length
Erectile organ
Rich in nerve endings
Genital corpuscles
Stratified squamous epithelium

Almond shape area enclosed by the labia

minora
Clitorisfourchette
6 openings
o Urethra
o Vagina
o 2 ducts of Bartholin Glands
o 2 ducts of paraurethral glands
(Skenes ducts)
Represents the functionally mature female
structure of the urogenital sinus
Fossa navicularis nulliparous women

--BARTHOLIN GLAND

Either side of the vaginal opening

Major vestibular glands
0.5-1 cm long glands
1.5-2 cm long ducts
Bartholin Gland Abscess

--URETHRAL OPENING

Midline of the vestibule

1-1.5 cm below pubic arch
Skenes Ducts- open on either side of the
urethral opening

--VESTIBULAR BULBS

Anlage of the corpus spongiosum of the

penis
Aggregation of veins beneath the mucous
membranes on either side of the vestibule
Vulvar hematoma

--VAGINAL OPENING AND HYMEN

Variations
Elastic and connective tissue
Stratified squamous epithelium
No glandular nor muscular elements
No nerve fibers
Newborn-vascular
Pregnant-thick epithelium rich in glycogen
Menopause-thin, focal cornifications
Adult women-surrounds the vaginal opening
more or less completely

o
o
o

Upper 3rd-cervicovaginal branch of

the uterine artery
Middle 3rd-inferior vesical artery
Lower 3rd- middle rectal, internal
pudendal artery

--VAGINAL OPENING AND HYMEN

Aperture varies in diameter

Virginity
Fimbriated type
Torn at posterior portion

--VAGINA

Musculomembranous structure
Connects the vulva to uterus
Anteriorly-bladder
Posteriorly-rectum
Upper portion-muellerian ducts
Lower portion-urogenital sinus
Anterior wall, 6-8cm in length
Posterior wall, 7-10 cm
Vaginal fornices
o Upper part of vagina
o Internal pelvic organs
o Access to peritoneal cavity
Rugae
Inner circular and outer longitudinal layer of
smooth muscle
No vaginal glands
Moist-cervical secretions
Rich in vascular supply

--PERINEUM

Pelvic & Urogenital Diaphragm

Pelvic Diaphragm
o Levator ani
o Coccygeus muscle

Urogenital diaphragm:external triangular area

b/n the ischial tuberosities and symphysis
pubis.
a) Deep traverse perineal muscles
b) Constrictor of the urethra
c) Internal and external fascial covering

Blood supply-internal pudendal a.

INTERNAL REPRODUCTIVE ORGANS

--UTERUS

Found between the bladder anteriorly and

posteriorly
Non pregnant-flattened pear
Upper triangular portion-Body/corpus
Lower cylindrical portion-cervix
Isthmus-Lower Uterine Segment
Prepuberty 2.5-3cm
Adult- 6-8cm
Cervix:
a) Prepuberty
2x longer than the body
b) Nulliparous-equal to the body
c) Multiparous-1/3, body-2/3
--CERVIX
External os before childbirth-small regular
opening after childbirth-transverse slit
Mucosa-single layer of ciliated columnar
epithelium
Nabothian Cyst
Cervical canal-fusiform
Internal os
External os
--BODY OF THE UTERUS
Wall
a) Serosal layer-peritoneum
b) Muscular layer-myometrium
c) Mucosal layer-endometrium
--ENDOMETRIUM
Lines the uterine cavity
Contains uterine glands
0.5mm-5mm thick
High columnar ciliated
2 layers:
a) Basalis
Remains during menses
Supplied by straight arteries
Non responsive to
hormones

b) Stratum functionale-comprises 2/3 of

endometrium
Compactum (superficial)
Spongiosum
Supplied by coiled arteries
Responsive to hormones
Sloughed off during
menstruation
--MYOMETRIUM
Muscular layer
Makes up major part of the uterus
Bundles of smooth muscles
No. of muscles diminishes caudally
o Cervix-made up of only 10%muscles
During Pregnancy the myometrium
undergoes hypertrophy with no significant
change in muscle content
--BROAD LIGAMENTS
Winglike structures consisting of a fold of
peritoneum extending from th lateral margin
of the uterus
Divides the pelvic cavity into anterior and
posterior compartments
--LIGAMENTS
Mesosalpinx/mesovarium
Inner 2/3
Fallopian tube attached
Infundibulopelvi/suspensory ligament of the
ovary
Outer 1/3
Fimbriated end to pelvic wall
Ovarian blood vessels
Cardinal Ligament made up of the densest
portion of the broad Ligament
o Continuous with the connective
tissue of the pelvic floor
o Transverse cervical ligament
o Mackenrodt ligament

ROUND LIGAMENT

Found below and anterior origin of

the oviducts
Gubermaculum testis in men

UTEROSACRAL LIGAMENTS

Postero-ligaments
Supravaginal portion of the cervix
From the lateral boundaries of the
pouch of douglas

1. Uterine Artery- branch of the

internal iliac artery
- ***2cm. Lateral to the
cervix as it crosses the ureter ureteral injury
2. Ovarian Artery- direct branch of the
aorta

BLOOD SUPPLY OF THE UTERUS

LYMPHATICS OF THE UTERUS

Internal iliac nodes

Periaortic nodes

Variations
Ovarian fossa of waldeyer
Young- smooth
Childbearing-corrugated
Elderly- markedly convoluted

OVIDUCTS

Fallopian Tube
Childbearing years:
2.5-5 cm in length
1.5-3cm in width
0.6- 1.5cm thick

BONY PELVIS

Interstitial
Isthmus
Ampullary
Infundibulum

OVARIES

Cortex
Outer Layer
Where the graafian follicle and
ova are seen
Tunica albuginea
Outermost portion
Medulla
Central portion
Arteries and veins

Bony wing thru which the body

weight is transmitted to the
lower extremities
Female pelvis-specially adapted
for childbearing
4 bones
o Sacrum
o Coccyx
o 2 inominate bones

PLANES & DIAMETERS OF THE PELVIS

PELVIC INLET

Ischial Spines
1. Great obstetric importance
2. Shortest diameter of the pelvic
cavity
3. Landmark thru which the presenting
part has descended into the true
pelvis

Pelvic Joints

Symphysis pubis
Joins the pelvic bone anteriorly
Sacroiliac joints- joins the pelvic
bone posteriorly
Relaxation of joints result from
hormonal changes
Mobility of pelvis @ termdue to the
upward gliding movement of the
sacroiliac joints
Greatest at dorsal lithotomy
Increase pelvic diameter 1.5-2cm

Posterior
o Promontory & alae of sacrum
Lateral
o Linea Terminalis
Anterior
o Horizontal pubic rami
o Symphysis pubis
4diameters:
o AP diameter-shortest
distance between Promontory
of the sacrum & symphysis
pubis
o Obstetrical Conjugate
o 10cm
Obstetric Conjugate
o Cannot be measured
clinically
o Estimated indirectly by
-1.5cm-2cm from diagonal
conjugate
o Distance from lower margin
of symphysis pubis to the
sacral promontory
Transverse diameter
o Greatest distance between 2
linea terminalis
o Intersects the obstetrical
conjugate
Oblique Diameter
Extends from one sacroiliac
synchondroses to the ileopectineal
eminence

MIDPELVIS
-

Level of ischial spines

Plane of LEAST pelvic dimensions
Interspinous diameter : 10 cm or
greater
o Smallest diameter of the
pelvis

PELVIC OUTLET
-

Android

o
o
-

2 traingular areas that have a

common base
Posterior triangle
o Apex: tip of sacrum
o Lateral: sacroiliac ligament
and ischial tuberosity
Anterior triangle
o Area under the pubic arch
Adequate: 8cm

PELVIC SHAPES
-

Gynecoid
o Seen in 50% of females
o Suited for delivery

Anthropoid
o AP > Transverse

Poor prognosis for vaginal

delivery
1/3 of females

Platypelloid
o Flattened gynecoid
o AP < TD

PHYSIOLOGY OF THE NORMAL MENSTRUAL

CYCLE
-

Ovary

o
o

o
o
o

Master gland
Determines the action of the
pituitary gland and
hypothalamus
2 million oocytes at birth
400,000 at puberty
Atresia/ apoptosis

400 follicles ovulate

EARLY PROLIFERATIVE PHASE

(addnl notes)
-

follicular phase of the menstrual

cycle
lasts from day 7 to day 14 of the
cycle
the mucosal glands become longer
and assume a curved or coiled
configuration
the stroma between glands also
increases by proliferation of
connective tissue cells
induced by estrogen

LATE PROLIFERATIVE PHASE

-

sorry picture is not clear, and i cant

find one in the net

SECRETORY PHASE

(addnl notes)
-

corresponding to days 15 to 27 of
the menstrual cycle

also known as the progravid or

luteal phase
glands stop proliferating and begin
to distend and secrete abundantly

in the middle region of the mucosa,

saccular outpouchings of the glands
are seen

changes observed in this stage are

induced

by progesterone following estrogen

priming.

** additional notes were taken from

the net
-

A. Resurfacing phase
corresponding to days 5 and
6 of the cycle
o remnants of the glands in the
basal zone of the mucosa
proliferate and migrate to
cover the raw surface of the
endometrium denuded from
its mucosa by menstrual flow
Proliferative Phase
Secretory Phase
o

B.
C.

The Pencil Parable

In the beginning the Pencil Maker spoke to the pencil

saying..

"There are five things you need to know before I send

you out into the world. Always remember them and
you will become the best pencil you can be."

FIRST: You will be able to do many great things, but

only if you allow yourself to be held in someone's
hand.

SECOND: You will experience a painful sharpening

from time to time, but this is required if you are to
become a better pencil.

THIRD: You have the ability to correct any mistakes

you might make.

FOURTH: The most important part will always be

what's inside.

FIFTH: No matter what the condition, you must

continue to write. You must always leave a clear
legible mar, no matter how difficult the situation.

The pencil understood, promising to remember, and

went into the box fully understanding its Maker's
purpose.

Now put yourselves in place of the pencil; always

remember it and never forget, and you will become
the best person you can be.

FIVE: On every surface you walk, you must leave your

mark. No matter what the situation, you must
continue to serve God in everything.

ONE: You will be able to do many great things, but

only if you allow yourself to be held in God's hand.
And allow other human beings to access you for the
many gifts you possess.

Every one of us is like a pencil... created by the Maker

for a unique and special purpose.

By understanding and remembering, let us proceed

with our life on this earth having a meaningful
purpose in our heart and a relationship with God
daily.

WE ARE MADE TO DO GREAT THINGS!

TWO: You will experience a painful sharpening from

time to time, by going through various problems, but
you'll need it to become a stronger person.

THREE: You will be able to correct mistakes you might

make or grow through them.

FOUR: The most important part of you will always be

what's on the inside. Develop your inner person.